Provider First Line Business Practice Location Address:
DEPT. OF VETERANS AFFAIRS, NFSG, DENTAL SERVICES-160
Provider Second Line Business Practice Location Address:
1601 SOUTHWEST ARCHER ROAD
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32608-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-379-4040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2006